How to Use Residency Placement Data to Plan Ahead

When choosing a medical school, applicants should incorporate residency placement data in their decision-making process. U.S. News published an article on this matter this past February, a couple months after the initial launch of our resource. In the article, several medical school deans comment on the importance of using match list data to navigate the application process.

How Med Schools Promote Specialties

Quinn Capers IV, a dean from Ohio State University College of Medicine, argues that a medical school will tend to naturally promote the specialties most emphasized by its affiliated medical centers. If the school’s clinical environment does not promote a given specialty, it is unlikely that the advising, shadowing and research opportunities will be sufficiently available to cultivate new or support existing interest in the field.

If, on the other hand, an affiliated medical center has a world-renowned department, then it stands to reason that more of their students may develop or maintain an interest in this department’s field. The increased availability of immersive experiences and mentorship in this specialty would naturally lead to more student interest in the field and the strong ties to a faculty well-established in this area would facilitate the matching process when the time comes.

Why the Affiliated Medical Center Matters

My own experience at medical school has aligned with Dr. Capers’ logic. At Boston University School of Medicine (BUSM), we are fortunate to be affiliated with Boston Medical Center. BMC is an incredible hospital for numerous reasons, and it was deemed a “High-Performing” hospital by U.S. News in its Neurosurgery and Neurology category of Hospital Rankings. The only higher-ranked specialties at BMC are geriatrics and nephrology, neither of which has a dedicated comprehensive residency to match into.

It cannot be purely coincidence that the percentage of Boston University’s graduating class matching into neurology has consistently been among the highest of the schools for which we have data on record. BUSM finished 8th, 12th and 6th in MedhounD’s Neurology Placement Percentage in 2014, 2015 and 2016 respectively, making the specialty BUSM’s most consistently high-ranking specialty in terms of placement percentage across that timeframe.

When I think back on my education thus far, it makes complete sense. Though the first year curriculum changed last year, for a long time the very first class at BUSM provided a sort of overview of patient care through the lens of behavioral science, psychiatry and neurology. Neurology faculty gave several interesting guest lectures throughout that first course that immediately piqued our interest in the field. Later, we took our first-year neuroscience class. It remains one of the most well-organized, informative and immersive classes of my medical education to date. The class culminated with an incredible lecture given by a neurosurgeon in which he showed us videos of his procedures and connected the relevant anatomy, physiology, and pathology together through his presentation. For many of my classmates and me, these experiences put neurology on our radar early on in our education.

How Does This Affect Your Application?

Of course, with this idea of using a projected career choice to guide application decision-making, we must acknowledge that a large proportion of students either don’t know what they want to go into when they start school or change their mind during their education. This is a point that has been raised numerous times to us since we started working on MedhounD. We completely understand the concern. However, we do not believe that it represents sufficient cause to not include residency placement data as one part of the process of choosing a medical school.

According to the 2015 AAMC Report on Residents, 52% of first year residents reported being most interested in a different specialty going into medical school than they eventually matched into. An additional 15% reported being undecided when they entered school and 7% did not respond.

First, we do not know what fraction of the 52% of students changed their mind because they went to a program incapable of sufficiently maintaining their interest in the field. Perhaps if they had used a more data-driven, outcomes-based approach, as we advocate, they would have landed at a school more geared towards nurturing their early interest.

Furthermore, the possibility of an applicant changing their mind in the future should not prevent them from using their current preferences to guide a decision in the present. When students are applying to college, they often say things like “I’m heading to School A because it has a great architecture program” or “I’m applying to Schools B and C because they have such strong engineering departments.” No one seems to question this reasoning. For some reason, we are satisfied with this logic. We trust that the 17-year-old high school student is more set on their future career than the adult premed, four years from becoming a licensed physician. We agree that the high school student should base their education decision in part on their future career, but we don’t want to apply the same logic to the premed.

Regardless of where you line up on the usefulness of specialty placement data in choosing a school, match list analysis offers many other applicable insights. Beyond guiding an applicant’s interest in a certain specialty, match lists also serve to convey a general idea about the overall competitiveness of specialties that students are going into.

And Then There’s Tuition (and Other Factors)…

For many applicants, tuition cost becomes a factor in their decision-making process if they are fortunate enough to gain acceptance to multiple programs. Unfortunately, it is often thought that a significantly cheaper state school education would limit their options compared to a more prestigious private institution. Therefore, many applicants will opt for the private route. By using match list analysis, however, applicants can make this decision via a much more logical, outcomes-based approach. In many cases, public institutions send students on to equally competitive specialties as more expensive private institutions do and at similarly sought-after residency programs. In such a case, a student could opt for the public school, save their money, and rest assured that they aren’t limiting themselves.

Geographical distribution and the specific residency programs matched to are also important factors. Graduates of some schools tend to cluster much more locally, while graduates from other schools spread out more across the country. Some schools send numerous students annually to specific programs, whereas other schools typically send students to a more diverse array of programs.

Using Match List Data as One Piece of the Puzzle

In the end, we wouldn’t advocate choosing a medical school purely based on its historical residency placement data. This would be every bit as poor of advice as choosing a school based purely on its median MCAT score, NIH funding dollars or location. Rather, we believe that match list analysis should represent one piece of each individual applicant’s unique decision-making process.

Evan is a student at Boston University School of Medicine. He graduated from Williams College in 2013 where he majored in chemistry and played on the hockey team. He spent a year with the Match Corps program before entering BUSM in 2014.